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Kidney Tubular Damage Secondary to Deferasirox: Systematic Literature Review

Deferasirox is a first-line therapy for iron overload that can sometimes cause kidney damage. To better define the pattern of tubular damage, a systematic literature review was conducted on the United States National Library of Medicine, Excerpta Medica, and Web of Science databases. Twenty-three re...

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Autores principales: Scoglio, Martin, Cappellini, Maria Domenica, D’Angelo, Emanuela, Bianchetti, Mario G., Lava, Sebastiano A. G., Agostoni, Carlo, Milani, Gregorio P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8700300/
https://www.ncbi.nlm.nih.gov/pubmed/34943300
http://dx.doi.org/10.3390/children8121104
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author Scoglio, Martin
Cappellini, Maria Domenica
D’Angelo, Emanuela
Bianchetti, Mario G.
Lava, Sebastiano A. G.
Agostoni, Carlo
Milani, Gregorio P.
author_facet Scoglio, Martin
Cappellini, Maria Domenica
D’Angelo, Emanuela
Bianchetti, Mario G.
Lava, Sebastiano A. G.
Agostoni, Carlo
Milani, Gregorio P.
author_sort Scoglio, Martin
collection PubMed
description Deferasirox is a first-line therapy for iron overload that can sometimes cause kidney damage. To better define the pattern of tubular damage, a systematic literature review was conducted on the United States National Library of Medicine, Excerpta Medica, and Web of Science databases. Twenty-three reports describing 57 individual cases could be included. The majority (n = 35) of the 57 patients were ≤18 years of age and affected by thalassemia (n = 46). Abnormal urinary findings were noted in 54, electrolyte or acid–base abnormalities in 46, and acute kidney injury in 9 patients. Latent tubular damage was diagnosed in 11 (19%), overt kidney tubular damage in 37 (65%), and an acute kidney injury in the remaining nine (16%) patients. Out of the 117 acid–base and electrolyte disorders reported in 48 patients, normal-gap metabolic acidosis and hypophosphatemia were the most frequent. Further abnormalities were, in decreasing order of frequency, hypokalemia, hypouricemia, hypocalcemia, and hyponatremia. Out of the 81 abnormal urinary findings, renal glucosuria was the most frequent, followed by tubular proteinuria, total proteinuria, and aminoaciduria. In conclusion, a proximal tubulopathy pattern may be observed on treatment with deferasirox. Since deferasirox-associated kidney damage is dose-dependent, physicians should prescribe the lowest efficacious dose.
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spelling pubmed-87003002021-12-24 Kidney Tubular Damage Secondary to Deferasirox: Systematic Literature Review Scoglio, Martin Cappellini, Maria Domenica D’Angelo, Emanuela Bianchetti, Mario G. Lava, Sebastiano A. G. Agostoni, Carlo Milani, Gregorio P. Children (Basel) Systematic Review Deferasirox is a first-line therapy for iron overload that can sometimes cause kidney damage. To better define the pattern of tubular damage, a systematic literature review was conducted on the United States National Library of Medicine, Excerpta Medica, and Web of Science databases. Twenty-three reports describing 57 individual cases could be included. The majority (n = 35) of the 57 patients were ≤18 years of age and affected by thalassemia (n = 46). Abnormal urinary findings were noted in 54, electrolyte or acid–base abnormalities in 46, and acute kidney injury in 9 patients. Latent tubular damage was diagnosed in 11 (19%), overt kidney tubular damage in 37 (65%), and an acute kidney injury in the remaining nine (16%) patients. Out of the 117 acid–base and electrolyte disorders reported in 48 patients, normal-gap metabolic acidosis and hypophosphatemia were the most frequent. Further abnormalities were, in decreasing order of frequency, hypokalemia, hypouricemia, hypocalcemia, and hyponatremia. Out of the 81 abnormal urinary findings, renal glucosuria was the most frequent, followed by tubular proteinuria, total proteinuria, and aminoaciduria. In conclusion, a proximal tubulopathy pattern may be observed on treatment with deferasirox. Since deferasirox-associated kidney damage is dose-dependent, physicians should prescribe the lowest efficacious dose. MDPI 2021-12-01 /pmc/articles/PMC8700300/ /pubmed/34943300 http://dx.doi.org/10.3390/children8121104 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Scoglio, Martin
Cappellini, Maria Domenica
D’Angelo, Emanuela
Bianchetti, Mario G.
Lava, Sebastiano A. G.
Agostoni, Carlo
Milani, Gregorio P.
Kidney Tubular Damage Secondary to Deferasirox: Systematic Literature Review
title Kidney Tubular Damage Secondary to Deferasirox: Systematic Literature Review
title_full Kidney Tubular Damage Secondary to Deferasirox: Systematic Literature Review
title_fullStr Kidney Tubular Damage Secondary to Deferasirox: Systematic Literature Review
title_full_unstemmed Kidney Tubular Damage Secondary to Deferasirox: Systematic Literature Review
title_short Kidney Tubular Damage Secondary to Deferasirox: Systematic Literature Review
title_sort kidney tubular damage secondary to deferasirox: systematic literature review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8700300/
https://www.ncbi.nlm.nih.gov/pubmed/34943300
http://dx.doi.org/10.3390/children8121104
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